Fractures

Vertebral fractures and crushes

Vertebral crush fractures are common complications in patients with osteoporosis. Osteoporosis is a disease that affects the quality of bone mass and is associated with a deficiency of vitamin D, Calcium, postmenopause, a sedentary life, smoking, as well as ages older than 60 years. Although osteoporosis is a painless disease, its complications can affect quality of life and increase mortality when severe. Crush fractures of the spine should be diagnosed with imaging tests, being an MRI of the spine the choice, because in addition to indicating that there is a fracture, it will allow us to appreciate if it is recent or not. It can also be done by means of a CT scan or conventional x-rays. Crush fractures have different degrees and depending on the loss of height, they can benefit from a kyphoplasty or a vertebroplasty. These treatments are percutaneous and consist of correcting the deformation of the vertebral body with the placement of a special cement that works quickly, stabilizing the fracture and returning the treated vertebra to a solid and resistant state. After percutaneous treatment, and the patient is discharged home the same day of the intervention and it is recommended to use a girdle or a corset to improve the acute inflammation caused by the crush fracture for a few weeks. In cases in which the crushing has been chronic and in which the MRI of the spine no longer shows bone edema, the recommended treatment is usually conservative, unless there is instability of the spinal segment, a deviation of the axis of the spine. spine, or spinal or root compression, where surgical treatment must be correctly assessed by a surgeon and team experienced in complex columns. In addition to carrying out a comprehensive control and having ruled out an underlying pathology that is not due to osteoporosis, measures such as physiotherapy, analgesia, preventive support treatment such as lumbar girdle or corset and recommendations to avoid high-impact physical activity, are the treatments that have shown the best benefit. Although in most cases medical treatment can be carried out by specialties such as Gynecology, Rheumatology and Primary Care Physician due to the diagnosis of osteoporosis, the assessment by a spine specialist to prevent fractures or assess decompensations of the axis of balance of the spine or its biomechanics is recommended.

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